The present invention relates to the harvesting of blood vessels and, more particularly, to a method and apparatus for endoscopic dissection and retraction of sections of blood vessels for use as a coronary artery bypass graft.
In connection with coronary artery bypass grafting (CABG), a blood vessel or vessel section, such as an artery or vein, is “harvested” (i.e., removed) from its natural location in a patient's body and is used elsewhere in the body. In CABG surgery, the harvested blood vessel is used to form a bypass between an arterial blood source and the coronary artery that is to be bypassed. Among the preferred sources for the vessels to be used as the bypass graft are the saphenous vein in the leg and the radial artery in the arm.
Endoscopic surgical procedures for harvesting a section of a blood vessel (e.g., the saphenous vein) subcutaneously have been developed in order to avoid disadvantages and potential complications of harvesting of the blood vessel. In the past, the harvesting was done through a continuous incision (e.g., along the leg) that exposed the full length of the desired vein section. The continuous incision had been necessary in order to provide adequate exposure for visualizing the vein and for introducing the surgical instruments to sever, cauterize and ligate the tissue and side branches of the vessel.
A more recent development has been a minimally-invasive technique that employs a small incision for locating the desired vessel and for introducing one or more endoscopic devices into the small incision.
The current technology for minimally invasive vessel dissecting and harvesting used such devices as bipolar scissors, bipolar cutter or ultrasonic tips to cauterize the vessels. Commercially available products for performing the endoscopic blood vessel harvesting procedure described above include the dissector device and the harvesting device that are sold together as the “VirtuoSaph™ Endoscopic Vein Harvesting System” from Terumo Cardiovascular Systems Corporation of Ann Arbor, Mich. Endoscopic vein harvesting systems are also shown in U.S. Pat. No. 6,660,016 to Lindsay, U.S. Pat. No. 7,077,803 to Kasahara et al., U.S. patent application publication Nos. 2005/0010242 and 2005/0192612 both in the name of Lindsay, and U.S. patent application publication numbers 2005/0154257A1, 2005/0159764A1, 2005/0148817A1, 2005/0149094A1 in the name of Kasahara et al., all of which are incorporated herein by reference in their entirety.
It would be desirable to be able to have an additional apparatus and method to capture the vessel and to cut and/or cauterized the vessel and any branches extending from the vessel.